Question 1

What is the minimum and maximum entry age for ACTIV ONE VYTL by Aditya Birla Health Insurance?

Accepted Answer

The minimum entry age for adults is 18 years, while dependent children can be covered from 91 days. There is no upper age limit for adult entry under this plan, providing flexible access for all ages.

Question 2

Till what age can my child stay covered under ACTIV ONE VYTL?

Accepted Answer

Dependent children can stay covered under ACTIV ONE VYTL until they reach 25 years of age, as long as they remain unmarried and financially dependent on the primary policyholder.

Question 3

Are unmarried children eligible under ACTIV ONE VYTL?

Accepted Answer

Yes, unmarried children are eligible for coverage under ACTIV ONE VYTL, provided they meet the defined dependent age criteria and remain financially dependent on the insured throughout the policy tenure.

Question 4

Can I add a new family member later under ACTIV ONE VYTL?

Accepted Answer

Yes, new family members such as a spouse, newborn child, or dependent parents can be added at renewal or specific life events, subject to underwriting, eligibility, and applicable waiting periods.

Question 5

Can my spouse and children be covered under a single sum insured in ACTIV ONE VYTL?

Accepted Answer

Yes, the policy allows you to cover yourself, spouse, and dependent children under a single family floater sum insured, offering consolidated coverage and cost efficiency for the entire family.

Question 6

Can I cover my parents under ACTIV ONE VYTL?

Accepted Answer

Yes, parents and parents-in-law can be included under ACTIV ONE VYTL, either under the same policy or separate coverage, depending on eligibility, underwriting acceptance, and applicable premium adjustments.

Question 7

Can family members be added mid-term under ACTIV ONE VYTL?

Accepted Answer

Mid-term addition of family members is allowed only during defined life events such as marriage or childbirth, subject to insurer approval and specific terms of the policy.

Question 8

What is the PED waiting period if I port to ACTIV ONE VYTL from another insurer?

Accepted Answer

The waiting period already served under the previous insurer is credited, reducing the remaining PED waiting period when porting to ACTIV ONE VYTL, ensuring continuity of benefits.

Question 9

Can I port my existing health policy to ACTIV ONE VYTL by Aditya Birla Health Insurance?

Accepted Answer

Yes, policyholders can port from another insurer, retaining continuity benefits and reducing waiting periods, subject to regulatory guidelines and underwriting approval.

Question 10

What is the PED waiting period after porting into ACTIV ONE VYTL?

Accepted Answer

After porting, the remaining PED waiting period is calculated by subtracting the duration already served under the previous policy from the standard waiting period.

Question 11

What unique benefits does ACTIV ONE VYTL by Aditya Birla Health Insurance offer compared to other policies?

Accepted Answer

Unique benefits include day-one chronic condition coverage, unlimited sum insured restoration, wellness-linked HealthReturns™, no room rent sub-limits, and comprehensive modern treatment coverage.

Question 12

Does ACTIV ONE VYTL come with any disease-wise sub-limits?

Accepted Answer

No, ACTIV ONE VYTL generally does not impose disease-wise sub-limits, offering broader flexibility for treatment claims, unless explicitly mentioned in the policy terms.

Question 13

Are room rent or ICU charges capped in ACTIV ONE VYTL?

Accepted Answer

No, the plan does not cap room rent or ICU charges, allowing patients to select the appropriate room without reducing eligible claim amounts.

Question 14

Is co-payment compulsory or optional under ACTIV ONE VYTL?

Accepted Answer

Co-payment is optional and generally applies only if chosen at purchase or required by age and underwriting terms; otherwise, it is not mandatory.

Question 15

Does ACTIV ONE VYTL offer a No-Claim Bonus (NCB)?

Accepted Answer

Yes, NCB increases the sum insured for every claim-free year, subject to maximum limits defined in the policy, enhancing coverage without raising premiums.

Question 16

Does ACTIV ONE VYTL provide any loyalty bonus?

Accepted Answer

Loyalty benefits include HealthReturns™ rewards and other wellness incentives for long-term policyholders, encouraging continuity and healthy lifestyle practices.

Question 17

Are preventive health check-ups included in all sum insured options under ACTIV ONE VYTL?

Accepted Answer

Yes, preventive health check-ups are included for all sum insured options at defined intervals, promoting early detection and proactive management of health conditions.

Question 18

Is there a grace period for renewing ACTIV ONE VYTL after expiry?

Accepted Answer

Yes, a grace period of 30 days is provided after policy expiry, allowing renewal without losing continuity benefits, though coverage may be temporarily paused during this period.

Question 19

What are the available sum insured options under ACTIV ONE VYTL?

Accepted Answer

ACTIV ONE VYTL provides flexible sum insured options, typically ranging from ₹5 lakh to ₹2 crore, enabling policyholders to select coverage according to individual health requirements and financial planning.

Question 20

Does ACTIV ONE VYTL offer maternity and newborn benefits?

Accepted Answer

Maternity and newborn benefits are not part of the base plan and may only be available through optional add-ons, with applicable waiting periods and policy-defined eligibility conditions.

Question 21

Are pregnancy-related complications covered under ACTIV ONE VYTL?

Accepted Answer

Pregnancy-related complications are generally excluded unless maternity coverage is purchased separately. Coverage for such cases is subject to waiting periods, eligibility criteria, and the specific terms of the policy.

Question 22

Are daycare procedures covered in ACTIV ONE VYTL?

Accepted Answer

Yes, daycare procedures that do not require 24-hour hospitalization are covered under ACTIV ONE VYTL, provided the treatment is medically necessary and performed in an empanelled hospital.

Question 23

Are pre- and post-hospitalization expenses covered under ACTIV ONE VYTL, and for how many days?

Accepted Answer

The plan covers pre-hospitalization expenses up to 90 days and post-hospitalization expenses up to 180 days, including investigations, medicines, and follow-up treatments linked to the primary hospital admission.

Question 24

Does ACTIV ONE VYTL include OPD coverage?

Accepted Answer

OPD coverage is included under certain wellness or chronic care programs within ACTIV ONE VYTL, supporting outpatient consultations, diagnostics, and health monitoring without requiring full hospitalization.

Question 25

Are room rent or ICU charges capped under ACTIV ONE VYTL?

Accepted Answer

No, there are no room rent or ICU sub-limits in ACTIV ONE VYTL, allowing policyholders to choose any room category without reductions in eligible claim amounts.

Question 26

Is chemotherapy covered under ACTIV ONE VYTL?

Accepted Answer

Yes, chemotherapy, including oral and intravenous treatments, is covered under ACTIV ONE VYTL either as an inpatient or daycare procedure, subject to sum insured and policy-defined inclusions.

Question 27

Are lifestyle diseases like diabetes or hypertension covered from day 1 under ACTIV ONE VYTL, or after a waiting period?

Accepted Answer

Seven specified chronic conditions, including diabetes and hypertension, are covered from day one, while other lifestyle-related illnesses are subject to the standard waiting period as defined in the policy.

Question 28

Does ACTIV ONE VYTL include mental health treatments or counselling?

Accepted Answer

Hospitalization expenses for mental health conditions are covered under ACTIV ONE VYTL, in accordance with regulatory guidelines, policy terms, and eligible inpatient treatments, including counseling where applicable.

Question 29

Does ACTIV ONE VYTL cover AYUSH/alternative treatments (Ayurveda, Homeopathy, Unani)?

Accepted Answer

Yes, inpatient AYUSH treatments such as Ayurveda, Homeopathy, Unani, Siddha, and Yoga are covered when provided in government-recognised or accredited hospitals, subject to the sum insured limit.

Question 30

Are diagnostic tests and pathology covered under ACTIV ONE VYTL?

Accepted Answer

Diagnostic tests and pathology expenses are covered when they are part of hospitalization or directly related pre- and post-hospitalization treatment under the policy.

Question 31

Is ambulance service covered under ACTIV ONE VYTL, and what is the limit?

Accepted Answer

Ambulance expenses are covered up to the defined limit per hospitalization, provided the ambulance is medically necessary for transporting the patient to or from a hospital.

Question 32

Is organ donor surgery covered under ACTIV ONE VYTL?

Accepted Answer

Yes, organ donor surgery expenses are covered under ACTIV ONE VYTL for both donor and recipient, subject to medical necessity and policy-defined terms and conditions.

Question 33

Are congenital conditions covered for children under ACTIV ONE VYTL?

Accepted Answer

Congenital internal conditions are covered after applicable waiting periods, while congenital external conditions are generally covered as per policy terms, subject to exclusions.

Question 34

Does ACTIV ONE VYTL cover vaccinations for adults and children?

Accepted Answer

Vaccinations are not included as standard benefits and may be available only through wellness add-ons or preventive health programs under the policy terms.

Question 35

Does ACTIV ONE VYTL provide international coverage?

Accepted Answer

International coverage is limited and generally applies only to emergencies or as specified under policy terms, subject to sum insured and eligibility criteria.

Question 36

Are occupational hazards or accident-related injuries covered under ACTIV ONE VYTL?

Accepted Answer

Yes, hospitalization expenses due to accidents, including occupational hazards, are covered under ACTIV ONE VYTL, subject to exclusions and policy-defined conditions.

Question 37

Are cosmetic or plastic surgeries covered under ACTIV ONE VYTL, and under what conditions?

Accepted Answer

Cosmetic or plastic surgeries are covered only when medically necessary due to accidents, burns, or congenital defects, but purely aesthetic procedures are excluded.

Question 38

Does ACTIV ONE VYTL include chronic disease management support?

Accepted Answer

Yes, ACTIV ONE VYTL offers structured chronic disease management programs for long-term monitoring, coaching, and care for selected chronic conditions.

Question 39

Are wellness, fitness, or reward-based benefits included in ACTIV ONE VYTL?

Accepted Answer

Wellness benefits like HealthReturns™, fitness rewards, and coaching support are included to incentivize healthy living and promote proactive health management.

Question 40

Does ACTIV ONE VYTL provide any death benefit?

Accepted Answer

No, ACTIV ONE VYTL is a health insurance plan and does not provide a separate death benefit payable to the nominee.

Question 41

What are PEDs, and when are they covered under ACTIV ONE VYTL?

Accepted Answer

Pre-existing diseases are medical conditions present before policy purchase. They are covered after completing the waiting period, except for day-one coverage chronic conditions.

Question 42

Is day-1 PED coverage available under ACTIV ONE VYTL?

Accepted Answer

Day-one coverage is available for seven specified chronic conditions, provided the conditions are declared and the policyholder meets eligibility criteria.

Question 43

What is the waiting period for PEDs under ACTIV ONE VYTL?

Accepted Answer

Pre-existing diseases generally have a waiting period of 36 months, except for the seven listed chronic conditions that receive day-one coverage under the plan.

Question 44

Does Aditya Birla Health Insurance offer top-up or super top-up options along with ACTIV ONE VYTL?

Accepted Answer

Yes, the insurer provides top-up and super top-up plans which can be purchased alongside ACTIV ONE VYTL to increase overall coverage at affordable premiums.

Question 45

Does ACTIV ONE VYTL offer cashless hospitalisation?

Accepted Answer

Yes, cashless hospitalisation is available at network hospitals, subject to pre-authorisation, allowing insured members to receive treatment without paying upfront for covered expenses.

Question 46

How long does Aditya Birla Health Insurance take to approve cashless claims for ACTIV ONE VYTL?

Accepted Answer

Cashless claim approvals are generally processed quickly, often within a few hours, provided all documents are submitted and hospital requirements are met.

Question 47

What documents are required to file a claim under ACTIV ONE VYTL?

Accepted Answer

Documents include claim form, hospital discharge summary, bills, prescriptions, medical reports, and identity proof, as required for inpatient, daycare, or reimbursement claims.

Question 48

Is pre-authorisation mandatory for hospitalisation under ACTIV ONE VYTL?

Accepted Answer

Yes, pre-authorisation is mandatory for planned hospitalisations, and emergency hospitalisation must be notified within the stipulated timeframe to avail cashless benefits.

Question 49

How many claims can I make in one policy year under ACTIV ONE VYTL?

Accepted Answer

There is no fixed limit on the number of claims in a policy year as long as the total claimed amount does not exceed the sum insured.

Question 50

Is the hospital network list available for ACTIV ONE VYTL, and can I avail treatment outside the network?

Accepted Answer

Yes, network hospital list is provided, and treatment outside the network is allowed through reimbursement, subject to policy terms and conditions.

Question 51

What is the claim settlement ratio of Aditya Birla Health Insurance for ACTIV ONE VYTL?

Accepted Answer

Aditya Birla Health Insurance maintains a strong overall claim settlement ratio, reflecting efficient claims processing and customer satisfaction, though ratios are reported at the company level.

Activ One VYTL

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What Is Activ One Vytl?

Vytl

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Aditya Birla Activ One Vytl Inclusions and Exclusions

Room Rent

Modern Treatment

Daycare Treatment

Annual Health Checkup

ICU Charges

Disease-wise sublimits

Restoration Benefit

Cumulative Bonus

Consumable Cover

Co-payment

Cashless Healthcare Providers

Initial Waiting Period

Specific Waiting Period

PED Waiting Period

Pre-Hospitalisation

Post-Hospitalisation

Outpatient Department Cover (OPD Expense)

Deductible Option

Coverage Options

Claim Settlement Ratio

Maternity Cover

AYUSH Treatment

Exclusions

Activ One Vytl Add-Ons and Riders

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